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The use of dry needling versus corticosteroid injection to treat lateral epicondylitis: a prospective, randomized, controlled study
Uygur E, Akta SB, Gul Yilmazoglu E
Journal of Shoulder and Elbow Surgery 2021 Jan;30(1):134-139
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Lateral epicondylitis (LE) is a common disease especially at middle age. To address LE different types of treatments have been used. Corticosteroid (CS) injections and dry needling (DN) are utilized options in the treatment. However, the question of which one is better has not been entirely discussed in the literature. We hypothesized that the use of DN to treat LE would be at least as effective as using CS injections. We compared the pain relief afforded and improvements in functional disability after DN and CS injection. METHODS: A total of 108 LE patients whose pain was not relieved by 3 weeks of first-line treatment were included in a randomized manner, using an online application into DN or CS groups (54 patients each). The minimum follow-up duration was 6 months. We recorded "Patient-rated Tennis Elbow Evaluation" (PRTEE) scores before treatment, and after 3 weeks and 6 months of treatment. RESULTS: Seven patients were excluded for various reasons, thus 101 patients were finally evaluated. Before treatment, the groups were similar in terms of age, symptom duration, and PRTEE score, but after treatment, DN-treated patients showed better improvement in the PRTEE score than CS-treated patients (p < 0.01). Both treatments were effective (both p < 0.01). From assessments at 3 weeks and 6 months post-treatment, PRTEE scores decreased over time. Four CS-treated patients (7.6%) developed skin atrophy and whitening. One DN-treated patient (2.04%) could not tolerate the pain of the intervention and withdrew from treatment. CONCLUSION: DN and CS injection afforded significant improvements during the 6 months of follow-up. However, compared to CS injection, DN was more effective. LEVEL OF EVIDENCE: Level II; randomized controlled trial; treatment study.

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